title: Alcohol-based hand-disinfection reduced children's absence from Swedish day care centers.
abstract: OBJECTIVE
  To determine if the use of alcohol-based hand-disinfection as a complement to regular hand washing at daycare centers (DCCs) can reduce the childhood rate of absenteeism.
  
  
  METHODS
  Children aged 0-6 years attending DCC were studied in a cluster randomized controlled trial during 30 weeks. Thirty matched pairs of DCCs were included in the study, where one of the DCCs was randomized to intervention and the other to control within each pair. The intervention consisted in children and staff using alcohol-based oily disinfectant gel containing 70% ethanol after regular hand washing. The main outcome was the rate of episodes of absence from DCC due to infection. A regression model was fitted at the individual level and controlling several possible confounders for illness. Absences were reported by the parents.
  
  
  RESULTS
  Differences in missing absence reports between the two groups led to only evaluating those 29 DCCs (1431 children) that were able to provide complete reports. In the multivariate regression, the intervention significantly reduced the rate of absenteeism of a child by 12% compared to a child in a control DCC (IRR 95% CI: 0.799-0.965).
  
  
  CONCLUSIONS
  Hand-disinfection used by children and staff significantly decreased childrens absences due to infections in Swedish DCCs.
authors.affiliation: Department of Clinical Microbiology, Unit for Infectious Disease Control, Orebro University Hospital, Orebro University, Orebro, Sweden. anne.lennell@orebroll.se
authors.forename: Anne
authors.initials: A
authors.lastname: Lennell
authors.forename: Sharon
authors.initials: S
authors.lastname: Kühlmann-Berenzon
authors.forename: Patricia
authors.initials: P
authors.lastname: Geli
authors.forename: Katarina
authors.initials: K
authors.lastname: Hedin
authors.forename: Christer
authors.initials: C
authors.lastname: Petersson
authors.forename: Otto
authors.initials: O
authors.lastname: Cars
authors.forename: Kerstin
authors.initials: K
authors.lastname: Mannerquist
authors.forename: Lars G
authors.initials: LG
authors.lastname: Burman
authors.forename: Hans
authors.initials: H
authors.lastname: Fredlund
mesh_terms: D000041:Absenteeism; D000438:Alcohols / Q000627:therapeutic use; D002648:Child; D002656:Child Day Care Centers / Q000379:methods*; D002675:Child, Preschool; D016000:Cluster Analysis; D004203:Disinfection / Q000379:methods*; D005260:Female; D005782:Gels / Q000627:therapeutic use; D006235:Hand Disinfection / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D013548:Sweden
chemical_list: D000438:Alcohols; D005782:Gels